How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $295.12 Typical High $371.54 | Professional | None | $288.40 | $295.12 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $478.63 Median $616.60 Typical High $645.65 | Facility | None | $478.63 | $616.60 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $616.60 | Professional | None | $302.00 | $302.00 | $616.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $44.67 | Professional | RR · Rental | $30.20 | $30.20 | $44.67 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $223.87 Median $223.87 Typical High $323.59 | Professional | UE · Used equipment | $223.87 | $223.87 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $794.33 | Facility | None | $776.25 | $776.25 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $616.60 | Facility | None | $389.05 | $389.05 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $2,754.23 | Professional | None | $281.84 | $389.05 | $2,754.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,137.96 | Facility | None | $912.01 | $954.99 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $741.31 | Professional | None | $380.19 | $501.19 | $741.31 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $426.58 | Facility | None | $331.13 | $331.13 | $426.58 |
United Setting Professional Modifier None Typical Low $165.96 Median $302.00 Typical High $436.52 | Professional | None | $165.96 | $302.00 | $436.52 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $147.91 Typical High $186.21 | Professional | 52 · Reduced service | $141.25 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $58.88 Typical High $74.13 | Professional | 53 · Discontinued | $57.54 | $58.88 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $44.67 Typical High $56.23 | Professional | 55 · Aftercare only | $42.66 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $29.51 Typical High $37.15 | Professional | 56 · Pre-op care only | $28.18 | $29.51 | $37.15 |
Where Indiana sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Indiana· 32nd of 51
$302
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.